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MONDAY, October 22, 2012 (HealthDay News) — A new survey of high school football players finds that more than half of those who felt some of the common symptoms of a concussion over the past two years didn't report them because they were afraid of being banned from playing.

More than half of the 134 athletes surveyed said they'd learned more about the symptoms of concussion after getting to high school. But even though concussions can lead to problems such as brain swelling and bleeding, less than 40 percent were worried about the long-term effects of concussions.

"The good news is that kids are paying attention and have gotten some increased knowledge," said survey author Dr. Michael Israel, a resident at the department of pediatrics at the University of Arkansas for Medical Sciences. "But they also know that due to state rules, if they have certain symptoms they have to go through a certain protocol to get back to play. Some of them are potentially hiding their symptoms to avoid being pulled."

Concussions occur when something hits the head and jars the brain. Many are minor, but concussions can lead to loss of consciousness and serious medical conditions like brain damage and bleeding in the brain.

Israel said he was inspired to launch the survey after serving as an on-site doctor during a high school football game. A player "got his bell rung" and went to be examined by the athletic trainer. But he didn't want the coach to know that there was any problem.

"He knew he wouldn't be able to go back in without going through some tests," Israel said. The player turned out to be fine after going through some tests to check his alertness and memory.

Israel created an online survey about concussions for varsity high school football players and sent it to several Arkansas school districts. It's not clear how many players got a chance to take the survey, but 134 responded. All had played football for at least one year.

Fewer than 10 percent said a doctor or team trainer had diagnosed them with a concussion. But about a third of football players said they'd suffered from concussion-like symptoms — like headache, dizziness, loss of balance and blurred vision — over the past two years. Of those, more than half said they didn't do anything for fear of being taken off the field.

The message of the study is that despite more knowledge about concussion, many football players haven't changed their behavior regarding their own possible injuries, Israel said. Still, he said, almost three of four said they'd report another player's concussion-like symptoms. "They were more likely to report a teammate than themselves," he said.

What to do? Israel said most of the players — 85 percent — said they got most of their information about concussion from their coaches. "There needs to be a way to get the important information to the coaches," he said.

Israel's research is to be presented Monday at the American Academy of Pediatrics (AAP) annual meeting in New Orleans.

Athletic trainers may also play an important role in concussion awareness. Another study presented at the AAP meeting found that Chicago area high schools with athletic trainers had more diagnosed concussions and fewer injuries overall, at least among sports programs for girls. Yet, fewer than half of U.S. high schools have trainers. It's not clear, though, that the presence of trainers is directly related to injury rates and concussion diagnoses.

Dr. Michael O'Brien, associate director of the Sports Concussion Clinic at Boston Children's Hospital, said teen athletes need to take responsibility, too. "A lot of the problems with young athletes is that they don't recognize it as a problem or they don't necessarily want to miss play and miss what often ends up being a short career," he said. "We have to expect more out of teenage athletes. If we treat them more like children, it's not going to be effective."

Because this study was presented at a medical meeting, the data and conclusions should be viewed as preliminary until published in a peer-reviewed journal.

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